Provider Demographics
NPI:1619859071
Name:BRAVO GARCIA, EVA (APRN- CNM)
Entity type:Individual
Prefix:
First Name:EVA
Middle Name:
Last Name:BRAVO GARCIA
Suffix:
Gender:F
Credentials:APRN- CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2611 N HAMPDEN CT APT 3N
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60614-1797
Mailing Address - Country:US
Mailing Address - Phone:312-404-5764
Mailing Address - Fax:
Practice Address - Street 1:2001 S CALIFORNIA AVE # 100
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60608-2486
Practice Address - Country:US
Practice Address - Phone:312-404-5764
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-07-24
Last Update Date:2025-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL209.032765367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife